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APPLICATION FOR CERTIFICATE OF OCCUPANCY l
CITY OF HUNTINGTON :BEACH
DEPARTMENT OF BUILDING & SAFETY
HUNTINCTON KAQ1 (PRINT OR TYPE ONLY) DATE
Address
Business Name .aT, YF
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Business Type Q,r1 ar t'►' e4 Se c, LA r,l r c
Distnc'gf
Occ Group
BUILDING OWNER f BUSINESS OW'NFFVVANAGER
Name alS4` e [S� lc tt S-h�CQI i Name — n 11
%CZ� Home /
Address Ae �`z`-"- Addre s
CityClZa�TeIZM- 22g4_ City �r:�✓c� Home
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THIS USE WOULD BE DESCRIBED AS:
❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER
EXISTING BUILDING ❑ CHANGE OF USE
Indicate former use, it any
SQUARE FT. OF BUILDING TO BE OCCUPIED.
Occupancy Gr
❑ CHANGE OF OCCUPANT
I/K ADDITIONAL OCCUPANT
Div.
1�
NOTICE:
1, Occupancy of any building is prohibited and a business license will no a issued until the building has been
inspected and a certificate of occupancy is issued.
2. No electrical service will be released for any existing building until the service has been inspected and
certified safe, All applicants for occupancy in an existing building are required to schedule an electrical
'fuse up' inspection in the Department of Community Development at the time this application is filed.
3. Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building or
premises in order to determine if a change may be made in the character of occupancy or use of the building
or premises which would place the building in a different division of the same grown of occupancy or �*r, a
different group of occupancy, a change of occupancy inspection fee of $ shall
be paid to the city.
4. Huntington Beach Fire Code Section 10,208 requires that building numbers must be a minimum of four (4)
inches in height with one half (1/2) inch stroke, and of a contrasting color from the background, These
numbers must be posted on your building in a location that is visible from the street.
5. Huntington Beach fire Code Section 10.. requires fire extinguisher selection and distribution per the
Nation//Fireection Ass cia>tion p Net 10 (see reverse side),
(FOR OFFICE USE ONLY)
ZONING.
OCCUPANCY GROUP— PLAN CHECK NO NO PARKING SPACES
OCCUPANT- LOAD PERMIT NO HEALTH DEPT APPROVAL —
NO, OF STORIES __.- ADMIN. ACTION - UTILITIES RELEASED _
CERTIFICATE OF OCCUPANCY f EE
APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE $
TOTAL
FORM 75-039 REV 2102 REORDER SAND DOLLAR 714,812-1148